Individual
MRS. LAURA JAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-CCC/SLP
Contact information
Practice address
2165 KENNERLY RD, IRMO, SC 29063-8696
(803) 732-9470
Mailing address
2165 KENNERLY RD, IRMO, SC 29063-8696
(803) 732-9470
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3661
SC
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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